Individual provider Active NPI

Angela M Tucker, CRNA

  • Certified Registered Nurse Anesthetist
  • Cincinnati, OH
National Provider Identifier
1023136124
Registry record updated Jun 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
20894 Issued in SC
Practice address
3333 Burnet Ave.
ML 2001
Cincinnati, OH 45229-3039
Phone
(513) 636-4408
Fax
(513) 636-7337
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 20894 SC Primary

Addresses

Primary practice location

3333 Burnet Ave.
ML 2001
Cincinnati, OH 45229-3039

Mailing address

3333 Burnet Ave.
ML 5021
Cincinnati, OH 45229-3039
Phone (513) 636-0356

Other names 1

  • Angela Moore Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150915002185 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173830700 Reassigns benefits to 1 organization
I20170728000103 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173830700 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

101 E Wood St
Spartanburg, SC 29303-3040
Phone (864) 560-1915

Hospital & facility affiliations

  • Spartanburg Medical Center Hospital, Spartanburg, SC, CCN 420007

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health-Upstate Current Accepting new patients
Spartanburg Medical Center CurrentSince Jan 7, 2019 Accepting new patients
Pathology Associates of Greenville PA Current Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Pelham Medical Center Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2023 Accepting new patients
Northstar Anesthesia of Ohio LLC CurrentSince Apr 6, 2016 Accepting new patients
Pelham Medical Center CurrentSince Jan 1, 2023 Accepting new patients
Prisma Health-Upstate CurrentSince Jul 10, 2017 Accepting new patients
Prisma Health-Upstate CurrentSince Jul 10, 2017 Accepting new patients
Spartanburg Medical Center Nurse Anesthetist, Certified Registered CurrentSince Jan 7, 2019 Accepting new patients

Locations

2615 E High St
Springfield, OH 45505
Phone (888) 861-3994

22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100

200 Fleetwood Dr
Easley, SC 29640
Phone (864) 442-7200

175 Patewood Dr
Greenville, SC 29615
Phone (864) 797-1000

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

830 S Buncombe Rd
Greer, SC 29650
Phone (864) 797-8000

250 Westmoreland Rd
Greer, SC 29651
Phone (864) 530-2108

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

729 SE Main St
Simpsonville, SC 29681
Phone (864) 271-8647

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498003200000",
    "number": "1023136124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE.",
            "address_2": "ML 5021",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293039",
            "telephone_number": "513-636-0356",
            "fax_number": "513-636-9286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE.",
            "address_2": "ML 2001",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293039",
            "telephone_number": "513-636-4408",
            "fax_number": "513-636-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2017-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "20894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "MOORE",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.